Healthcare interoperability - Healthcare Industry Lens

Healthcare interoperability

Healthcare interoperability refers to health data exchange between information systems like electronic healthcare records (EHR), pharmacy systems, diagnostic imaging systems, laboratory systems, and claims systems. With interoperability, health data can be communicated between electronic systems, between organizations, and across geographical boundaries with standardized protocols.

Enabling interoperability requires that data be captured in electronic systems, with standards for the content, transport, vocabulary/terminology, privacy and security, and identifiers. The Healthcare Information and Management Systems Society (HIMSS), a globally recognized thought leader on healthcare interoperability, defines four levels of interoperability as:

  • Foundational: Establishing interconnectivity so that systems can securely exchange data.

  • Structural: Defining and adopting standards for the format, syntax, and organization of data.

  • Semantic: Using standardized coding vocabularies so that the parties exchanging data can have a shared understanding of its meaning.

  • Organization: Managing the governance and legal aspects of exchanging data between organizations and individuals. This level also covers consent for how an individual’s data will be shared.

Characteristics of functional interoperability solutions include:

  • Using a published standard to structure and transmit health data. Many standards are currently used across healthcare, such as Health Level Seven Version 2 (HL7 v2), HL7 Version 3 (HL7 v3), HL7 Fast Healthcare Interoperability Resources Version 4 (FHIR), X12 Electronic Data Interchange (EDI) transactions used in healthcare benefits coordination and claims processing, and the Digital Imaging and Communications in Medicine (DICOM) standard for storing and transferring medical images.

  • Exposing either an API or an integration server to other systems seeking to exchange data.

  • Checking received data for conformance to the interoperability standard being used.

  • Being able to apply transformations to data received or sent and mapping the internal formats of systems of record, like EHRs, to a structural and semantic form dictated by the standard.

  • Facilitating secure authorization and launch of user-facing applications, often with protocols like SMART on FHIR.